HOW IT WORKS

A clear path from denial to next steps

Submit denial details

Tell SkipperWin what was denied and share the clinical context behind the care.

Get the right response

Medical necessity denials get a real, clinically grounded appeal letter. Billing and coding issues get a clear correction path instead — SkipperWin routes each denial to the response that actually helps, not a one-size-fits-all letter.

Track outcomes

Built in Ledger to help you keep a simple record of activity and outcomes across your revenue recovery efforts.

Covers UHC/Optum, Aetna, and Cigna nationwide, and BCBS in Massachusetts.

THE INTAKE

You answer questions. We build the argument.

Your office manager enters the denial details and clinical context; no clinical background required.

SkipperWin walks through the same criteria (LOCUS, payer-specific medical policy) a reviewer uses to evaluate medical necessity, asking for the specific clinical facts that actually move an appeal: functional impairment, symptom severity, what lower levels of care were tried and why they weren't enough.

Nothing generic, nothing guessed; every argument is built from what you actually enter.

HOW WE ROUTE EACH DENIAL

Not every denial needs the same fight

Medical necessity denials get the full clinical letter; a real, argued case built from your intake.

Billing and coding issues, like a missing modifier or POS code, get a fast, specific correction path instead of a generated letter that wouldn't help anyway.

Authorization and procedural denials get clear next-step guidance.

Every denial code gets a real answer — just not always the same kind of answer, because they're not the same kind of problem.

LETTER STRENGTH SCORE

Know how strong your letter is before you send it.

Every generated letter comes with a Letter Strength Score; a transparent rating based on how complete and clinically specific your intake was.

The score reflects real factors like documented functional impairment and evidence of failed lower levels of care, so you know exactly what would make the case stronger before you submit.

BEFORE YOU SUBMIT

You're always the last word.

Every letter is built for your review, not automatic submission.

SkipperWin drafts the argument, your team confirms it's accurate, your provider reviews the clinical content before it goes out

Sample Medical Necessity Letter- Excerpt

Patient J.M., a 34-year-old adult, presents with major depressive disorder, recurrent, moderate to severe (F33.1), with functional impairment across multiple domains directly relevant to LOCUS Dimension II (Level of Functioning). J.M. has been unable to maintain consistent employment attendance over the past two months, has withdrawn from previously regular social contact with family, and reports difficulty completing basic self-care tasks including meal preparation and hygiene on approximately half of days per week per clinician documentation. These functional deficits, combined with persistent depressive symptoms rated as moderate-severe on standardized clinical assessment, meet LOCUS criteria supporting continued outpatient treatment at the current level of care. J.M.'s treatment history further supports this level: a prior attempt at less-intensive biweekly outpatient sessions in (enter month/year) resulted in clinical deterioration, with worsening depressive symptoms and one emergency department visit for suicidal ideation (enter date), demonstrating that a lower level of care was insufficient to maintain clinical stability. Weekly outpatient psychotherapy at the current frequency represents the least restrictive level of care clinically appropriate to J.M.'s presentation.

This is an excerpt from a real SkipperWin-generated letter, built from a fully fictional case — no real patient information was used. Every argument like this one is built from your team's own intake answers, not a template. Yellow-highlighted placeholders mark spots your team fills in manually before submission — SkipperWin never collects or stores identifying patient information.